So, the basic rules and tips for working alone on nights are:
- Shift starts, so don’t forget to punch in!
- First thing you should do is compare the treatment orders in the computer charting with what is on your RT Treatment sheet. You'll want to make sure all ordered treatments are on your sheet.
- Prioritizing is the key to working alone at night. Most urgent therapies must be done first – use common sense.
- Check printers for new orders every hour
- All new orders must be signed and dated
- New oxygen orders must be checked and started immediately
- New treatment orders must be completed within 1 hours
- Respond to ER pages within 5 minutes, or call ER with a good reason why you are unable
- For respiratory arrest, chart the following:
o Airway management
o If intubated, chart intubation
o If on vent, chart vent start
o If on BiPAP, chart BiPAP Start
o Chart # of hours on vent or BiPAP
- Do oxygen rounds early
- Do Q-shift vent assessments early. This includes:
o Breath sounds
o Cuff pressure
- Chart oxygen rounds anytime after midnight
- Be prepared for a morning rush and try to have all your charting done before 4:00 a.m. This includes:
o All floor treatments
o All ER treatments
o PRN treatments
o Vent checks and suctioning
o Vent assessments
o File all EKGs
- QID treatments can be started anytime after midnight. So if the patient is awake take advantage of this
- Make sure any airway boxes used are restocked
- Make sure any dirty vents are cleaned and put together
- If needed, make ABG kits and neb kits
- Before you go home, double check that all therapies are charted and charted correctly with proper meds.It’s now 7:30 a.m.
- Shift ends, don’t forget to punch out!
- Have a good sleep